Year in review: Health care law produces state battles

JACKSON – The Affordable Care Act – commonly known as Obamacare – produced big political battles in Mississippi in 2013, as it did in other states.

BRYANT

Despite a persistent effort by Democrats in the Legislature, the state’s Republican leadership blocked efforts to allow expansion of Medicaid, a key component of the Affordable Care Act, to cover people earning up to 138 percent of the federal poverty level – about $15,000 annually for an individual, or about $32,000 for a family of four.

And Republican Gov. Phil Bryant successfully beat back efforts by Republican Insurance Commissioner Mike Chaney to run the health insurance exchange in Mississippi. Under the federal law, states had the option to petition to run their own online exchange where people could shop to purchase a health care plan.

Chaney maintained the site would be more responsive to Mississippians if his office operated it. But Bryant objected, saying he did not want the state to participate in any aspect of the new law. In the end, the federal government, seeing the split in the state’s political leadership, opted to deny Chaney’s request.

Thus Mississippi was thrown into the problematic federal exchange.

The blunders associated with the rollout of the federal site were apparent in Mississippi. As of mid-December, according to Chaney’s office, 809 people in Mississippi signed up for health care through the website where many will be eligible for a federal subsidy to help with the purchase of insurance. A spokesperson said those numbers should be updated in January.

On the Medicaid front, Democrats were able to block the approval of a Medicaid budget in the 2013 regular session, demanding a vote on expansion.

In a late June special session, the Democrats got a semblance of a vote, which they lost, and the regular Medicaid program was funded with no expansion.

The fight is likely to continue.

Bryant and other Republicans say the state cannot afford the expansion and that Obamacare is a boondoggle. Proponents cite studies that show the Mississippi economy would benefit significantly from Medicaid expansion.

Without the expansion, some people will not have access to health care. People earning less than 100 percent of the federal poverty level are not eligible for a federal subsidy to help purchase private insurance, under the assumption they would be covered by the Medicaid expansion.